Determination of anomalous pulmonary venous return with high-pitch low-dose computed tomography in pediatric patients.

BACKGROUND: In this study, we aimed to image pulmonary venous return anomalies and associated cardiovascular and pulmonary abnormalities by high-pitch low-dose computed tomography (CT) in children.

MATERIALS AND METHODS: Forty-one patients with total or partial anomalous pulmonary venous return anomalous between May 2012 and June 2019 were retrospectively reviewed. The anomalies were determined using high-pitch low-dose CT. The patients' mean age was 3 years (6 months to 15 years), and 24 of them were female.

RESULTS: There were 10 patients with total pulmonary venous return anomalies (TPVRA) and 31 patients with partial pulmonary venous return anomalies (PPVRA). Six patients with TPVRA had the supracardiac type (60%), two had the cardiac type (20%), and two had the mixed type (20%). All patients with TPVRA had a large atrial septal defect (ASD), one patient also had patent ductus arteriosus, and one patient had right cardiac hypertrophy. Forty cases of PPVRA were found in 31 patients. Twenty-seven of them were right-sided (67%), and 13 were left-sided (33%). Twenty patients (65%) also had an additional cardiovascular anomaly (ASD in 12 patients, persistent superior vena cava in 4 patients, patent ductus arteriosus in 3 patients, and aortic coarctation in 2 patients). Of the 27 patients with right-sided PPVRA, it drained into the superior vena cava in 19 patients, the right atrium in 5 patients, and the inferior vena cava in 3 patients. In left-sided cases, the anomalous pulmonary vein drained into the left innominate vein in 9 patients, and in 4 patients, there were accessory pulmonary veins that drained into the left innominate vein. Many of the patients had additional lung anomalies, including pneumonic infiltration (n=12), atelectasis (n=8), and lobar emphysema (n=5), and some of these findings coexisted.

CONCLUSIONS: Anomalous pulmonary venous drains and associated cardiac and extra-cardiac anomalies can be detected reliably and quickly with high-pitch low-dose CT without sedation in pediatric patients.